Trojánek Milan, Grebenyuk Vyacheslav, Herrmannová Kristýna, Nečas Tomáš, Gregorová Jana, Kucbel Martin, Šín Robin, Roháčová Hana, Stejskal František
Cas Lek Cesk. 2020 Spring;159(2):55-66.
By the end of 2019 the first cases of severe pneumonia of unknown origin were reported in Wuhan, China. The causative agent was identified as a novel b-coronavirus SARS-CoV-2 and the disease was named COVID-19. Since the beginning of 2020, the infection has spread worldwide, which led the WHO to declare COVID-19 a public health emergency of international concern and to characterize the current situation as a pandemic. The transmission occurs mainly via respiratory droplets and the incubation period ranges from 2 to 14 days. Most cases are mild, but some patients develop severe pneumonia with acute respiratory distress, septic shock and multi-organ failure. The most common symptoms include fever, dry cough, myalgia and shortness of breath. Characteristic laboratory findings are normal white blood cell count or mild leukopenia, marked lymphopenia, in severe cases elevated CRP, procalcitonin, LDH, and D-dimer are commonly found. Typical imaging findings include multifocal peripherally distributed ground-glass opacities or consolidations, interlobular septal thickening, crazy paving appearance and cystic changes. The overall case fatality rate is estimated to range from 1 to 3 %, however, it is dependent on age and underlying medical comorbidities. Current potential treatment options include hydroxychloroquine, remdesivir, lopinavir/ritonavir and convalescent plasma.
2019年底，中国武汉报告了首例不明原因的重症肺炎病例。病原体被确定为一种新型β冠状病毒SARS-CoV-2，该疾病被命名为COVID-19。自2020年初以来，这种感染已在全球范围内传播，这使得世界卫生组织宣布COVID-19为国际关注的突发公共卫生事件，并将当前形势定性为大流行。传播主要通过呼吸道飞沫进行，潜伏期为2至14天。大多数病例症状较轻，但一些患者会发展为重症肺炎，伴有急性呼吸窘迫、感染性休克和多器官功能衰竭。最常见的症状包括发热、干咳、肌痛和呼吸急促。典型的实验室检查结果是白细胞计数正常或轻度白细胞减少、明显淋巴细胞减少，在重症病例中，常见CRP、降钙素原、乳酸脱氢酶和D-二聚体升高。典型的影像学表现包括多灶性外周分布的磨玻璃影或实变、小叶间隔增厚、铺路石样外观和囊性改变。总体病死率估计在1%至3%之间，然而，这取决于年龄和潜在的合并症。目前可能的治疗选择包括羟氯喹、瑞德西韦、洛匹那韦/利托那韦和康复期血浆。
